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Diseases / Viruses - Autoimmune

Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - Hi, I have recently been diagnosed as HIV positive, following pneumonia a year ago. I am now fully recovered from that but need to know what the implications are for recreational scuba diving. Should I stop diving? If I can carry on, what precautions do I need to take? Do I need a medical? Will I get insurance still?

A - Having HIV/AIDS shouldn’t, in this day and age, prevent you from doing anything, and is certainly not a bar to diving. There are some special considerations though. Firstly, even in otherwise unaffected individuals, there are often subtle changes in a variety of brain functions, for example behavioural and motor skills, eye movement, coordination and spatial orientation. These may be more noticeable in the underwater environment and could potentially threaten safety. Secondly, no doubt many divers will recognise the bloodstained snot/spittle that emerges from masks on surfacing, and this is a potential (although unproven) route of transmission of the virus. However, it doesn’t survive for more than a few minutes outside the body, so buddy breathing techniques and use of rental regulators (which are regularly disinfected) pose no real risk. Thirdly, some of the drugs that are used to treat HIV have side effects that may mimic symptoms of DCI – typically tinglings in the extremities, aches in muscles and joint pains – which may cause diagnostic confusion if a bend is suspected. Indeed these symptoms can occur as part of AIDS itself. And finally there is also the question of an increased susceptibility to infections. Venomous marine critters are no respectors of a compromised immune system and may cause long-lasting and severe illnesses.

All that sounds pretty gloomy, but in reality many of these problems do not seem to have materialised in individuals whose HIV is under control, such as yourself. Suitable assessment prior to diving ought to pick up those with complications likely to endanger themselves or their fellow divers. Get a medical done with a diving doc, tell them all the facts, and if they sign you off then insurance shouldn’t be a problem. So if you are in good overall health, there’s no reason you shouldn’t start taking lessons.

Q - Can you please tell me if HIV prevents you from scuba diving? I've been positive for about six years, but have been in good overall health (reasonable T-cell count) and have never had to take any medication for my condition. I am considering taking lessons, so I would appreciate your advice.

A - Having HIV/AIDS shouldn’t, in this day and age, prevent you from doing anything, and is certainly not a bar to diving. There are some special considerations though. Firstly, even in otherwise unaffected individuals, there are often subtle changes in a variety of brain functions, for example behavioural and motor skills, eye movement, coordination and spatial orientation. These may be exacerbated in the underwater environment and could potentially threaten safety. Secondly, no doubt many divers will relate to the bloodstained snot/spittle that emerges from masks on surfacing, and this is a potential (although unproven) route of transmission of the virus. Thirdly, some of the drugs that are used to treat HIV have side effects that may mimic symptoms of DCI – typically tinglings in the extremities, aches in muscles and joint pains – which may cause diagnostic confusion if a bend is suspected. Indeed these symptoms can occur as part of AIDS itself. And finally there is also the question of an increased susceptibility to infections. Venomous marine critters are no respectors of a compromised immune system and may cause longlasting and severe illnesses.

All that sounds pretty gloomy, but in reality many of these problems do not seem to have materialised in individuals whose HIV is under control, such as yourself. Suitable assessment prior to diving ought to pick up those with complications likely to endanger themselves or their fellow divers. The virus doesn’t survive for more than a few minutes outside the body, so buddy breathing techniques and use of rental regulators (which are regularly disinfected) pose no real risk. So if you are in good overall health, there’s no reason you shouldn’t start taking lessons.

(other dive medical questions)



   


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